Provider Information for 1316507601
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Dr. DEBORAH HEYLIM CHUNG DDS
Sex: Female
NPI: 1316507601
Last Updated: 2024-06-24
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316507601 | ||||||||
| Enumeration Date | 2019-06-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5730 UNION MILL RD CLIFTON, VA 20124 United States Phone: 703-818-0007 | Fax: | ||||||||
| Primary Practice Address | 5730 UNION MILL RD CLIFTON, VA 20124 United States Phone: 703-818-0007 | Fax:703-818-0010 | ||||||||
| Secondary Practice Address(es) | 6735 LEA BERRY WAY | ||||||||
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